October 15-21, 2017, marks this year’s observance of Healthcare Quality Week—a week dedicated to celebrating the contributions of and increasing awareness about the profession of healthcare quality.
Healthcare quality professionals serve in important roles. According to the National Association for Healthcare Quality (NAHQ), which sponsors the week, the work of healthcare quality professionals is critical for improving outcomes, increasing efficiencies, and reducing costs. Every year, over 200,000 to more than 400,000 patients are subject to preventable harm that leads to their death. Healthcare quality professionals are dedicated to making an impact on and reducing this number. Yet, NAHQ comments that healthcare quality professionals frequently go “unnoticed” because they often work behind the scenes.
The bipartisan Defeat Malnutrition Today coalition is especially cognizant and appreciative of the work of healthcare quality professionals and how their work can contribute to improving malnutrition care in this country. Through improving patient nutrition care, healthcare quality professionals can have an even more noticeable impact.
Malnutrition is a major concern because it can cause adverse and costly outcomes. Malnutrition, simply stated, is the lack of proper nutrients for one to function. It is an imbalance of protein, calories, or other vitamins or minerals that negatively impacts a person’s body mass, functions, and/or ultimate clinical outcomes. Malnutrition can lead to increased fall risk, slower recovery times, re-hospitalizations and readmissions, and death. Malnutrition is also a patient safety risk, as those who are malnourished are more likely to experience a healthcare-acquired condition.
The prevalence is shocking—up to one in two older adults are at risk for malnutrition. Malnutrition significantly increases hospital costs as well; poor nutritional status can cause up to a 300% increase in costs and, on average, an extension of hospital stays by four to six days.
A 2017 Administration for Community Living, Center for Policy and Evaluation report on malnutrition comments “At least 1/3 of patients of all ages in developed countries, including the U.S., are malnourished when admitted to the hospital, and, if untreated, about 2/3 will have their nutritional status decline during their hospitalization.” Yet, the American Society for Parenteral and Enteral Nutrition comments that every 60 seconds, 10 hospitalized patients with malnutrition go undiagnosed.
While malnutrition is a prevalent and potentially costly problem, it is also preventable. The National Blueprint: Achieving Quality Malnutrition Care for Older Adults calls for a range of strategies to prevent and reduce malnutrition among older adults, including “improv[ing] access to high-quality malnutrition care and nutrition services by adopting clinically relevant malnutrition quality measures in public and private accountability programs across the care continuum.”
The Centers for Medicare and Medicaid Services (CMS) have stated that malnutrition screening and assessment are important for better patient outcomes and that there is an opportunity for hospitals to improve nutrition screening and assessment practices. This can start by making healthcare quality professionals aware of the recently introduced malnutrition care electronic clinical quality measures and on-line toolkit developed by the Malnutrition Quality Improvement Initiative. Another resource is the Health Research and Education Trust’s Preventing Malnutrition Change Package.
As the healthcare industry continues its transformation to demonstrate value, healthcare quality professionals are faced with new challenges and opportunities. One critical opportunity that cannot be underestimated is improving malnutrition care. The annual cost of disease-associated malnutrition in older Americans is more than $50 billion. Quality malnutrition care has been shown to create savings and improve patient care. CMS is considering implementing the malnutrition measures nationally; quality professionals should advocate for these measures with CMS as well.
The bottom line is, recognizing the key role of healthcare quality professionals and engaging them in implementing these malnutrition electronic clinical quality measures will directly help healthcare institutions reduce preventable harm. It will also directly benefit older adult patients by improving their health and physical function outcomes. Institutional implementation of these measures is vital, and healthcare quality professionals can lead the way in their own institutions and in advocacy nationwide.